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Diet and Nutrition By popular demand our nutritional message board. This board will be monitored by a Registered RD who is certified in oncology by the American Dietetic Association

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Old 12-06-2011, 01:58 PM   #1
'lizbeth
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Diet vs. Exercise. Eat right, but . . .

We've all heard it before: In order to maintain a healthy heart and decrease your risk of dying from cardiovascular issues, it's all about working out and watching your weight. But which of the two has a bigger impact?
According to a new study, fitness may trump diet.
The findings, published in Circulation: Journal of The American Heart Association, suggest that maintaining or improving fitness levels can reduce death risk -- even after researchers accounted for confounding factors, like changes in body mass index (the commonly used measurement of a person's weight relative to his or her height).
"Fitness loss with age is associated with a higher risk of all-cause and CVD [cardiovascular disease] deaths, after controlling for weight change," said Dr. Duck-chul Lee, PhD, the study's lead researcher and a physical activity epidemiologist at the University of South Carolina's Arnold School of Public Health.
"However, weight, BMI or even percent body fat change were not associated with death risk," he continued.
In the new study, Lee and his co-authors looked at more than 14,000 men -- most of whom were white and middle or upper class. They had an average age of 44, were slightly overweight (BMI of 26) and were relatively fit.
For every unit of increased fitness, which researchers gauged using METs or Metabolic Equivalents (basically, a measurement of how hard your body is working based on a treadmill test) over six years, they saw a 19 percent lower risk of heart disease and stroke-related deaths and a 15 percent lower risk of death from any disease. The authors followed up with people for slightly more than 11 years.

"What this study was trying to determine is what's more important for cardiovascular disease -- fitness or fatness?" said Dr. Marc Gillinov, a staff surgeon in the department of thoracic and cardiovascular surgery at the Cleveland Clinic and author of the forthcoming book "Heart 411." "Its conclusion is that overall fitness appears to be more important than BMI, more important than fatness, when it comes to determining whether you're going to be at risk for dying from CVD."
The message, Lee said, is that we may need to focus more on maintaining or improving fitness rather than worrying too much about weight gain -- at least in terms of public health. He said efforts should focus on the importance of regular exercise and upping daily activity levels, by doing small things such as walking the dog and taking the stairs instead of the elevator.
However, Lee cautioned that because the study looked at mostly normal or slightly overweight men, it does not make clear whether the results would apply to severely obese people. Generally, a BMI of 18.5 to 24.9 is considered normal, 25 to 29.9 is considered overweight and 30 or higher is considered obese.
Gillinov echoed the idea that the new findings should not be extrapolated for people who are considered obese.
He added that the research may have greater implications for the scientific community than for individuals -- for most people, he said, their fitness level tends to be linked to their weight. What the finding does is underscore the importance of exercise when it comes to health -- a message he said can be underrepresented in our thinking on these issues.
"The message is that you are doing yourself a lot of good with exercise," he said. "If you're someone who's fit but is finding it hard to drop those last five to 10 pounds, don't beat yourself up about it too badly. And if you're someone who's overweight but active, I'd say keep working on it, because you're doing some good. This is a reminder that fitness is really important."
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Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
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Old 12-27-2011, 05:19 AM   #2
Paula O
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Re: Diet vs. Exercise. Eat right, but . . .

Thanks for sharing this. I am struggling with my weight--it's been an issue for me for years on and off. I decided not to wait til Jan 1st to get back on track, though that is most tempting as the house is still loaded with Christmas treats, have a couple invitations out this week still, etc.-TODAY is day#1 for me to get back to eating and exercising the way I want to be. Have others here also gained weight during cancer treatment? I thought cancer was supposed to make you skinny. I asked my oncologist and he said most of his breast cancer patients gain weight with steroids, etc.

My profile picture here was taken in May, after doing the alternative cancer treatment prior to conventional medicine, feeling slim and trim then yikes, have packed on an embarrasing many pounds since then. Enough is enough. I feel awful overweight and am mad at myself for gaining so much weight this year. I want to turn to God when stressed, not chocolate!

For years I exercised 1 to 1 1/2 hours/day six days a week and loved it. I'm so exhausted now, exercise went out the window except for walking sometimes. I am going to have to build back up slow and easy. For years i ate salad while my family ate pizza and I ate fruit while they ate junk. It made me so upset that i got cancer, felt very disillusioned and disappointed that my healthy lifestyle did not prevent cancer and i've allowed junky eating to creep back in... BAD idea! During chemo i ate lightly for a week afterwards because of nausea then was ravenous the next two weeks before chemo again. Are there others who want to join me in getting to their ideal weight (either up or down) with a healthy eating plan that suits the person best and get into a good exercise routine in 2012? There are many things out of our control but what we put in our mouths is and we can increase our activity as we are able. We can do it!

Here's to a healthier 2012!

Paula
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Old 12-27-2011, 10:32 AM   #3
Jackie07
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Re: Diet vs. Exercise. Eat right, but . . .

Paula,

Many patients gain weight during cancer treatment due to steroid (the cause of water retention)and other factors. I gained 10-15 lbs both in 2003 and 2007 and the weight went down gradually/naturally after treatment ended.

The advice from my doctors was to exercise regularly. The advice from my sister-in-law (who's a nutrition professor and dietician/consultant) was to eat good food (a lot of protein and avoid junk food) and not to worry about the weight while undergoing treatment.

Walking is the best exercise. When I'm not walking outdoors, I tried to walk around the house while swinging arms and then bending my knees once every 4, 5 steps. I also count 'foot-tapping' (while sitting in the couch as exercise ... [Mother has also taught me how to move my legs and arms/hands while lying in bed.]

To a healthier 2012!
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http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
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NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
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hptc hemangioma
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GI - > yogurt
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Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016

"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

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Last edited by Jackie07; 12-27-2011 at 05:12 PM..
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Old 01-13-2012, 12:47 PM   #4
Mtngrl
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Re: Diet vs. Exercise. Eat right, but . . .

I gained weight with breast cancer treatment--and I was overweight to start with.

The good news is I'm pretty fit. I had heard before that fat people who exercise are healthier than skinny people who don't. But now that I have cancer I'm persuaded that the best way to keep it at bay is to be both thin and active, so I'm refocusing my efforts. At my age, every bite that goes in my mouth needs to be nutrient dense.
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4/19/11 Diagnosed invasive ductal carcinoma in left breast; 2.3 cm tumor, 1 axillary lymph node, weakly ER+, HER2+++
4/29/11 CT scan shows suspicious lesions on liver and lungs
5/17/11 liver biopsy
5/24/11 liver met confirmed--Stage IV at diagnosis
5/27/11 Begin weekly Taxol & Herceptin for 3 months (standard of care at the time of my DX)
7/18/11 Switch to weekly Abraxane & Herceptin due to Taxol allergy
8/29/11 CT scan shows no new lesions & old lesions shrinking
9/27/11 Finish Abraxane. Start Herceptin every 3 weeks. Begin taking Arimidex
10/17/11--Brain MRI--No Brain mets
12/5/11 PET scan--Almost NED
5/15/12 PET scan shows progression-breast/chest/spine (one vertebra)
5/22/12 Stop taking Arimidex; stay on Herceptin
6/11/12 Started Tykerb and Herceptin on clinical trial (w/no chemo)
9/24/12 CT scan--No new mets. Everything stable.
3/11/13 CT Scan--two small new possible mets and odd looking area in left lung getting larger.
4/2/13--Biopsy of suspicious area in lower left lung. Mets to lung confirmed.
4/30/13 Begin Kadcyla/TDM-1
8/16/13 PET scan "mixed," with some areas of increased uptake, but also some definite improvement, so I'll stay on TDM-1/Kadcyla.
11/11/13 Finally get hormone receptor results from lung biopsy of 4/2/13. My cancer is no longer ER positive.
11/13/13 PET scan mixed results again. We're calling it "stable." Problems breathing on exertion.
2/18/14 PET scan shows a new lesion and newly active lymph node in chest, other progression. Bye bye TDM-1.
2/28/14 Begin Herceptin/Perjeta every 3 weeks.
6/8/14 PET "mixed," with no new lesions, and everything but lower lungs improving. My breathing is better.
8/18/14 PET "mixed" again. Upper lungs & one spine met stable, lower lungs less FDG avid, original tumor more avid, one lymph node in mediastinum more avid.
9/1/14 Begin taking Xeloda one week on, one week off. Will also stay on Herceptin and Perjeta every three weeks.
12/11/14 PET Scan--no new lesions, and everything looks better than it did.
3/20/15 PET Scan--no new lesions, but lower lung lesions larger and a bit more avid.
4/13/15 Increasing Xeloda dose to 10 days on, one week off.
7/1/15 Scan "mixed" again, but suggests continuing progression. Stop Xeloda. Substitute Abraxane every 3 weeks starting 7/13.
10/28/15 PET scan shows dramatic improvement everywhere. All lesions except lower lungs have resolved; lower lungs noticeably improved.
12/18/15 Last Abraxane. Continue on Herceptin and Perjeta alone beginning 1/8/16.
1/27/16 PET scan shows cancer is stable.
5/11/16 PET scan shows uptake in some areas that were resolved on the last two scans.
6/3/16 Begin Kadcyla and Tykerb combination
6/5 - 6/23 Horrible diarrhea from K&T together. Got pneumonia.
7/15/16 Begin Kadcyla only every 3 weeks.
9/6/16 Begin radiation therapy on right lung lesion that caused the pneumonia.
10/3/16 Last of 12 radiation treatments to right lung.
11/4/16 Huffing and puffing, low O2, high heart rate, on tiniest bit of exertion. Diagnosed as radiation pneumonitis. Treated with Prednisone.
11/11/16 PET scan shows significant improvement to radiated part of right lung BUT a bunch of new lung lesions, and the bone met is getting worse.
11/22/16 Begin Eribulin and Herceptin. H every 3 weeks. E two weeks on, one week off.
3/6/17 Scan shows progression in lungs. Bone met a little better.
3/23/17 Lung biopsy. Tumor sampled is ER-, PR+ (5%), HER2+++. Getting Herceptin and Perjeta as a maintenance treatment.
5/31/17 Port placement
6/1/17 Start Navelbine & Tykerb
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Old 07-30-2014, 08:30 AM   #5
Jackie07
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Re: Diet vs. Exercise. Eat right, but . . .

Found an abstract to an article today while researching for a discussion in another forum . Thought I'd share it here:

Anticancer Res. 2014 Jan;34(1):39-48.

Counseling patients on cancer diets: a review of the literature and recommendations for clinical practice.

Huebner J1, Marienfeld S, Abbenhardt C, Ulrich C, Muenstedt K, Micke O, Muecke R, Loeser C.


Author information




Abstract


BACKGROUND:

Many cancer patients use cancer diets.

MATERIALS AND METHODS:

We listed 13 cancer diets simulating an internet search for which we systematically reviewed clinical data. In the next step we derived recommendations on counseling patients using a Delphi process.

RESULTS:

We evaluated the following diets: raw vegetables and fruits, alkaline diet, macrobiotics, Gerson's regime, Budwig's and low carbohydrate or ketogenic diet. We did not find clinical evidence supporting any of the diets. Furthermore, case reports and pre-clinical data point to the potential harm of some of these diets. From published recommendations on counseling on complementary and alternative medicine, we were able to derive 14 recommendations for counseling on cancer diets.

CONCLUSION:

Considering the lack of evidence of benefits from cancer diets and potential harm by malnutrition, oncologists should engage more in counseling cancer patients on such diets. Our recommendations could be helpful in this process.
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Jackie07
http://www.kevinmd.com/blog/2011/06/doctors-letter-patient-newly-diagnosed-cancer.html
http://www.asco.org/ASCOv2/MultiMedi...=114&trackID=2

NICU 4.4 LB
Erythema Nodosum 85
Life-long Central Neurocytoma 4x5x6.5 cm 23 hrs 62090 semi-coma 10 d PT OT ST 30 d
3 Infertility tmts 99 > 3 u. fibroids > Pills
CN 3 GKRS 52301
IDC 1.2 cm Her2 +++ ER 5% R. Lmptmy SLNB+1 71703 6 FEC 33 R Tamoxifen
Recc IIB 2.5 cm Bi-L Mast 61407 2/9 nds PET
6 TCH Cellulitis - Lymphedema - compression sleeve & glove
H w x 4 MUGA 51 D, J 49 M
Diastasis recti
Tamoxifen B. scan
Irrtbl bowel 1'09
Colonoscopy 313
BRCA1 V1247I
hptc hemangioma
Vertigo
GI - > yogurt
hysterectomy/oophorectomy 011410
Exemestane 25 mg tab 102912 ~ 101016 stopped due to r. hip/l.thigh pain after long walk
DEXA 1/13
1-2016 lesions in liver largest 9mm & 1.3 cm onco. says not cancer.
3-11 Appendectomy - visually O.K., a lot of puss. Final path result - not cancer.
Start Vitamin D3 and Calcium supplement (600mg x2)
10-10 Stopped Exemestane due to r. hip/l.thigh pain OKed by Onco 11-08-2016

"I WANT TO BE AN OUTRAGEOUS OLD WOMAN WHO NEVER GETS CALLED AN OLD LADY. I WANT TO GET SHARP EDGED & EARTH COLORED, TILL I FADE AWAY FROM PURE JOY." Irene from Tampa

Advocacy is a passion .. not a pastime - Joe

Last edited by Jackie07; 07-30-2014 at 08:32 AM..
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